India’s GDP could rise by at least $22 billion by closing gender gap in healthcare: Study

The women’s health gap equates to 75 million years of life lost due to poor health or early death per year

A new report by the McKinsey Health Institute in collaboration with the WEF (World Economic Forum), Closing the women’s health gap: A $1 trillion opportunity to improve lives and economies, finds that while women live longer than men, they spend 25 per cent more time in poor health. This gap is addressable, and closing it could result in an additional 7 days of healthy living per year for each woman globally. It would also boost global GDP by $1 trillion by 2040.

Key findings

While women live longer than men, they spend 25 per cent more of their lives in debilitating health.

• 95 per cent of the women’s health burden stems from conditions that affect both women and men. Female-specific conditions, including sexual and reproductive health (SRH) and maternal, newborn and child health (MNCH), and endometriosis, among others, account for ~5 per cent of the women’s health burden.
• 56 per cent is due to health conditions that are more prevalent and/or manifest differently in women.
• In India, top 4 of the 10 conditions contributing to highest health burden for women are conditions that affect men and women similarly, namely neonatal disorders (12 per cent of total share of female health burden), ischemic heart disease (8 per cent), diarrheal diseases (7 per cent), and lower respiratory infections (6 per cent). Four others of the top 10 conditions were those that affect women disproportionately (namely, chronic obstructive pulmonary disease, stroke, dietary iron deficiency, and low back pain).
• In India and globally, the conditions that affect females disproportionately are also among the conditions with highest share of Years Lived with Disability (YLD) of the total Disability-adjusted life years (DALY) burden. In India, dietary iron deficiency, lower back pain, depressive disorders and migraines are the top four conditions that contribute the most to women’s years of life lived in disability.
• India’s GDP could rise by at least $22 billion by closing the gender gap in healthcare. Top conditions contributing most to the total GDP impact of closing the gender health gap are premenstrual syndrome, other gynecological diseases, migraine, depressive disorders and anxiety disorders.

Global findings: According to the report, root causes of gaps in women’s health can be attributed to four primary areas globally: science, care delivery, investment and data.

Science: The study of human biology defaults to the male body, which hinders understanding of sex-based biological differences, resulting in many treatments being less effective for women than men.

• Historically, men have both led and been the subject of study of medicine and biology. The majority of animal models have been done on male specimens. Questions around sex-based differences were rarely investigated or recorded, with the assumption – now known to be false – that there are few important differences in the functioning of organs and systems in men and women beyond reproduction.
• This results in >50 per cent of interventions (which have sex-disaggregated research) being less effective for women than men. Examples include combined inhalers for asthma which have a 20ppt lower effectiveness for women than men; or biological drugs for rheumatoid arthritis which are 24ppt less effective for women than men.

Care delivery: Women are more likely to face barriers to care, experience diagnostic delays, and receive suboptimal treatment.

• Women often face barriers, stigma and bias in healthcare systems designed and run by men, which means women are less likely to receive the same intervention for a given disease. For example, men have a >3x higher likelihood to receive cardiac resynchronisation therapy to control arrhythmia compared to women.
• When it comes to affordability and access, counteracting the rise in healthcare costs while benefiting patients and insurance providers could be achieved through approaches such as value-based care. For example, given the amount of time, multiple tests, and providers a woman may see before an endometriosis diagnosis, a revised model of care could offer a holistic and patient-centric approach that provides a faster diagnosis, reduces costs for a healthcare system or payer, and ultimately improves outcomes.

Investment: There has been lower investment in women’s health conditions relative to their prevalence. This drives a reinforcing cycle of less scientific understanding of women’s bodies and limited data to de-risk new investment.

• Global life sciences R&D efforts primarily focus on conditions with a high contribution of years of life lost (YLL) to the overall disease-adjusted life years (DALY), i.e. deadly diseases. This has often disadvantaged women and girls because they have a higher probability of being affected by conditions that affect quality of life (years lived with a disability, YLDs) rather than length of life.
• In digital healthcare, FemTech companies received only 3 per cent of the total digital health funding.

Data: Health burdens for women are systematically underestimated, with datasets that exclude or undervalue important conditions.

• Only ~50 per cent of health interventions show disaggregated data by sex.
• Women’s health burden is undercounted due to low diagnosis rates:

• no diagnosis or late diagnosis leads to conditions not showing up in claims data and therefore being overlooked as they seem smaller than they are in reality
• Late diagnosis—or lack of diagnosis—might mean conditions are not represented in claims data and will be overlooked. A study conducted in Denmark across the span of 21 years showed that women were diagnosed later than men for more than 700 diseases. For cancer, it took women two and a half more years to be diagnosed.
• IHME data (which is the most extensive global dataset currently underestimates prevalence of menopause by more than 50 per cent – their current numbers show only a third of women go through menopause when more than 99 per cent of women experience menopause and 92 per cent of them are symptomatic

Addressing the gaps and shortcomings in women’s health could reduce the time women spend in poor health by almost two-thirds, which would help 3.9 billion women live healthier lives.

• Addressing the health gap could:
  • Add 7 more days of healthy living for each woman annually
  • Add at least $1 trillion to the global economy by 2040
  • Generate the equivalent impact of 137 million women accessing full-time positions by 2040
• For every $1 invested in women’s health, ~$3 is projected in economic growth.

To improve health equity and foster economic growth, stakeholders need to develop a cooperative and comprehensive strategy.

• Invest in women-centric research to fill the knowledge and data gaps in women-specific conditions, as well as in diseases affecting women differently and/or disproportionately.
• Systematically collect and analyse sex-, ethnicity- and gender- specific data to have more accurate representation of women’s health burden and the impact of different interventions.
• Enhance access to gender-specific care, from prevention to diagnosis and treatment.
• Incentivise new financing models.
• Establish business policies that support women’s health.
• Raise awareness and support advocacy to bring attention to the women’s health gap.